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门诊心理健康劳动力是否准备好拯救生命?在实施全州自杀预防计划之前的自杀预防培训、知识、自我效能和临床实践。

Is the outpatient mental health workforce ready to save lives? Suicide prevention training, knowledge, self-efficacy, and clinical practices prior to the implementation of a statewide suicide prevention initiative.

机构信息

Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.

New York State Psychiatric Institute, New York, NY, USA.

出版信息

Suicide Life Threat Behav. 2021 Apr;51(2):325-333. doi: 10.1111/sltb.12708.

Abstract

OBJECTIVE

Many public health approaches to suicide prevention emphasize connecting at-risk individuals to professional treatment. However, it is unclear to what degree the outpatient mental health workforce has the requisite knowledge and skills to provide the evidence-based care needed to help those at risk. In this project, prior to the implementation of a statewide suicide prevention initiative, we assessed the baseline suicide prevention training and clinical practices of the New York State outpatient mental health workforce, a group likely representative of the broader U.S. clinical workforce.

METHOD

A workforce survey of suicide prevention training and clinical practices was administered to 2,257 outpatient clinicians, representing 169 clinics serving approximately 90,000 clients. Clinicians were asked to complete the survey online, and all responses were confidential.

RESULTS

Clinicians reported substantial gaps in their suicide prevention knowledge and training. The vast majority reported moderate self-efficacy working with suicidal clients and endorsed using evidence-based assessment procedures, but varied in utilization of recommended intervention practices.

CONCLUSIONS

This study highlights gaps in clinicians' training and clinical practices that need to be overcome to provide evidence-based suicide care. Promisingly, positive associations were found between training and clinician knowledge, self-efficacy, and use of evidence-based practices.

摘要

目的

许多公共卫生方法都强调将有自杀风险的个人与专业治疗联系起来。然而,目前尚不清楚门诊心理健康工作者在多大程度上具备提供所需循证护理的必要知识和技能,以帮助那些有风险的人。在这个项目中,在实施全州自杀预防倡议之前,我们评估了纽约州门诊心理健康工作者的自杀预防培训和临床实践的基线情况,该群体可能代表了更广泛的美国临床工作者。

方法

对 2257 名门诊临床医生进行了自杀预防培训和临床实践的劳动力调查,这些临床医生代表了 169 家诊所,为大约 90000 名客户提供服务。临床医生被要求在线完成调查,所有的回答都是保密的。

结果

临床医生报告说,他们在自杀预防知识和培训方面存在很大差距。绝大多数人报告说,他们在处理有自杀倾向的客户方面有中等程度的自我效能感,并认可使用基于证据的评估程序,但在推荐的干预措施的使用上存在差异。

结论

这项研究强调了临床医生在培训和临床实践方面存在差距,需要克服这些差距,提供循证的自杀护理。有希望的是,培训与临床医生的知识、自我效能感和使用基于证据的实践之间存在积极的关联。

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